Medicare Open Enrollment Options

Medicare plan open-enrollment periods are different for a Medicare Supplement compared to a Medicare Advantage HMO or  Part D Rx plan.

NEW TO MEDICARE – If you are new to Medicare, you will have a 6 month open enrollment for any medicare supplement plan available in your area.  If you choose a Medicare Advantage or Part D plan, you will have 3 months to enroll.

LEAVE EMPLOYER HEALTH PLAN – If you are already on medicare but are covered under an employer health insurance plan, when you leave the health plan you will have 2 months to choose either a Medicare Supplement or Medicare Advantage.

MOVE TO NEW LOCATION – If you move to a new location where your current Medicare Advantage plan is not available, you will have 2 months to choose a new Medicare Advantage or Medicare Supplement.  If you move with a Medicare Supplement, you can keep your current Med Supp because they are considered “portable” and there is no difference in coverage or access to doctors in your new location.

MEDICARE ADVANTAGE PLAN TERMINATES – If your Medicare Advantage plan terminates mid year or at renewal, you have a 2 month open enrollment to enroll in a new Medicare Advantage or Medicare Supplement of your choice.

BIRTHDAY RULE – (California & Oregon only).  If you are currently enrolled in a Medicare Supplement policy, you can change companies starting  on your birthday and moving forward 30 days, with no medical review, the change is guaranteed.

ANNUAL OPEN ENROLLMENT PERIOD (October 15 – December 7)  All company and plan changes are only for Medicare Advantage and Medicare Part D Rx plans.  This open enrollment period has nothing to do with Medicare Supplement policies.  All changes during the “annual open enrollment period take effect on January 1.

There are many other open-enrollment options available then the ones mentioned above. Please feel free to contact me so we can discuss your situation.

Anyone on Medicare who has either a Medicare Advantage plan or a stand-alone Medicare Part D Rx plan should compare and review the plans available to them every year during open-enrollment which runs from October 15 to December 7.  Both types of plans can change quite dramatically from year to year.

Medicare Part D Rx … The companies offering Medicare Part D Rx plans can change the plan deductible amounts, move common drugs to a higher tier level, causing higher out-of-pocket amounts, and of course increase the plan monthly premiums.

Medicare Advantage HMO & PPO plans … also change from year to year. Deductibles, premiums, drug formulary lists and many other parts of the plan benefit outline.

Medicare Supplement Plan & Rate

Sometimes the change is incremental and you may not notice much the first year or two,  But after a few years of change the plan may not even resemble the plan you originally enrolled in. Other times the change is quite drastic and you will feel the difference immediately.  Feel free to contact me during open enrollment, I’ll be happy to give you the updated information and inform you of the changes.

The changes are guaranteed and not subject to medical review.  If you are on Medicare A and B and live in the county where the plan is available, you are eligible for the plan.

Most companies disclose the changes and plan outlines for the following year on or near October 1.  This is a good time to look at your current plan and company along with the other available choices in your county.

County specific … Medicare Advantage and Part D plans are typically County specific.  Meaning you must live in the County where the plan is available.  There may be plans in the adjoining county but are not available to you, or you may have access to good plans but your county neighbors don’t.

Medicare Supplement plans on the other hand are available to anyone in the State where the plan is offered.  They also do NOT have annual open enrollment periods, but can be applied to anytime of the year as long as you answer the health questions on the enrollment forms.  If you are new to Medicare you have a 6 month initial open enrollment period to enroll regardless of health status.  And if coming off of an employer group health plan you have two months to enroll … guaranteed, as mentioned above.

Questions?  Call or email anytime.

John Conner
916-682-1117
john@johnconner.com

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Author: John

Medicare Options along with Individual and Group International Medical Insurance Options.